Cumming J G, Spence V A, Jain A S, Stewart C, Walker W F, Murdoch G
Lancet. 1987 Sep 12;2(8559):613-5. doi: 10.1016/s0140-6736(87)92997-7.
50 below-knee amputations were carried out in 45 patients (25 men and 20 women), mean (SD) age 73 (10.5) years. The mean survival time was 22(16) months after the operation. In each patient the healing potential of a below-knee amputation was determined preoperatively by segmental pressure studies and thermographic delineation of skin perfusion. 33 of the stumps healed by first intention, in 14 healing was delayed but occurred without the need for further surgery, and 3 stumps healed after local wedge excision. The initial mobilisation rate was 90%. Thus, there are no grounds for carrying out an initial above-knee amputation to save the patient a further operation.
对45例患者（25名男性和20名女性）实施了50例膝下截肢手术，平均（标准差）年龄73（10.5）岁。术后平均生存时间为22（16）个月。术前通过节段性压力研究和皮肤灌注热成像描绘，确定了每例患者膝下截肢的愈合潜力。33个残端一期愈合，14个延迟愈合但无需进一步手术，3个残端经局部楔形切除后愈合。初始活动率为90%。因此，没有理由为避免患者再次手术而最初实施膝上截肢。
